Date: 19 October 1954
Cert: 22399
Place of Death: County: Knott
City or Town: Bath - Rural
Length of stay (in this place): (blank)
Street address or location: Home
Usual Residence of Deceased: State: Ky.
County: Knott
City or Town: Bath - Rural If rural give
location:
(blank)
Full Name: Allie DURHAM
Date of Death: 19 October 1954
Sex, Color or Race, Marital Status: Female, White,
Married
Date of Birth: 09 July 1909
Age: 45 years
Usual Occupation: Housewife
Kind of Industry or business: (blank)
Birthplace: Knott Co., Ky.
Father's Name: Seymore AMBURGEY
Mother's Maiden Name: Martha Ann COLLINS
Was deceased ever in armed forces: no
Social Security No.: none
Informant: Mr. Newt DURHAM
Disease/condition directly leading to death: Carcinoma of
cervix
Interval between onset and death: 05 (illegible) years
Due to: (blank)
Other significant conditions: (blank)
Date of Operation: (blank)
Major findings of operation: (blank)
Autopsy: No
Accident, suicide, or homicide: (blank)
Place of injury: (blank)
City or Town, County, State: (blank)
Time of Injury: (blank)
Injury occurred at work: (blank)
How did injury occur: (blank)
I hereby certify that I attended deceased from 10 June 1954 to
05 October 1954, that I last saw the deceased alive on 05
October 1954, and
that death occurred at (blank), from the causes and on the
date stated above.
Date signed: 08 November 1954
Address: Whitesburg, Ky.
Signature: J. E. Campbell, M.D.
Burial, Cremation or Removal: (blank)
Date: 20 October 1954
Name of Cemetery or Crematory: Seymore Amburgey
Location: Bath, Ky.
Date received by local registrar: 12 November 1954
Registrar's Signature: Myrtle Slone
Funeral director & address: John Everage, Hindman,
Ky.
Transcribed by Debbie Tamborski, 23 February 2011 |